A posterior prolapse often causes the sensation of something ‘coming down.’ It may leave you with the feeling of not having emptied your bowel, or that you need to press on the back wall of the vagina in order to empty your bowel.

A posterior prolapse happens most often in women that have given birth, though it can still affect women who have never been pregnant. This condition can make sex painful and make it difficult to keep tampons in.

What are the benefits of this procedure?

The goal of this procedure is to tighten the support tissues between your bowel and vagina, as well as to remove the bulge in your vagina.

What are the alternatives to surgery?

If your prolapse is only minor, your doctor will suggest that you try simple treatments such as pelvic-floor exercises or treating constipation if you are experiencing it. If these methods are not effective, then they will suggest that you undergo a posterior repair.

Another alternative to this surgery involves using mesh to replace the affected support tissues.

What will happen during the operation?

The operation generally lasts around 30 minutes and will be carried out using general anaesthetic. During the procedure a consultant will make an incision on the back (posterior) wall of your vagina, which allows them to push the bowel back into its correct position. The support tissues along the back wall of your vagina are then tightened using stitches.

A small part of your vaginal wall will be removed to enable your doctor to remove any surplus tissue that caused the posterior prolapse. If the muscles on both sides of the entrance to your vagina are also weak, your consultant will use stitches to tighten these (perineal repair).

Risks and complications

Any risks or complications will be discussed in advance of your treatment with your expert consultant.

Recovery

Post-surgery, it is common to experience a little bleeding or discharge from the vagina. However, your consultant should be notified straightaway if this becomes heavy.

Most patients are able to go home within 3 days of the operation. You should rest for 2 weeks whilst carrying out any exercises that were recommended to you by your doctor. Do not have sex for at least 6 weeks or until the discharge and/or bleeding has ceased.

During recovery you should refrain from standing for too long or lifting heavy items. Most patients return to work after 6-8 weeks; however your doctor will tell you when you are well enough to do so.

Exercising on a regular basis can help speed up the recovery process, though you should consult a professional for advice beforehand. Continue with your pelvic-floor exercises as soon as you feel well enough to do so, and continue doing these for life. Make sure you drink lots of fluid and increase your intake of fibre to ensure that your bowel movements are soft. Doing the above will limit the chances of the prolapse returning and reduce the risk of you suffering from constipation.

Summary

A posterior repair is often recommended to people if simple methods to treat their prolapse have failed. After the operation, your bowel should be more supported and there should be no bulge in your vagina.

References:
EIDO Healthcare Limited - The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.

The information on this document should not replace advice that your relevant health professional would give you.